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How long should I wait between two joint replacements?
Six weeks is the bare minimum. That is roughly how long it takes your body to recover physiologically from a joint replacement: your heart, your lungs, your blood count. It applies whether you are doing one knee and then the other, one hip and then the other, or a knee and then a hip.
Most people wait about three months, until they feel fully recovered from the first surgery. Beyond that, I tell patients the timing is up to how they feel.
Do I really need both sides done?
Maybe not right away. Some patients are surprised by this. They come in sure they need both joints replaced, and we do the worst one first. That new joint does its job, it takes pressure off the other side, and the other side often feels better than expected. Many of those patients decide to wait a year or longer before doing the second, and some wait longer still.
That is a personal decision, and there is no wrong answer. The same question applies to the second side as to the first: are you ready, and is the joint limiting the life you want? The signs it is time for a joint replacement are the same the second time around.
“Some patients are actually quite surprised. They think they need both joints done. But once we do the worst one first, it does its job and takes pressure off the other side, and they end up deciding to wait a year or longer. That’s a personal decision, and it’s up to how they feel.”
Will my second joint replacement be easier?
Usually, yes, but not always.
The second surgery is often easier because you know what to expect. You know how to prepare, you know what the first week feels like, and much of the anxiety of the unknown is gone.
But the second one is never exactly the same as the first. Sometimes it is harder. Sometimes there is more swelling, for reasons nobody can fully explain. So go in hoping it will be easier, without assuming it. And if you notice something different the second time, tell your surgeon.
“If you’ve had two surgeries, they’re never going to be the same. Typically I’ve found the second to be easier, because patients know what to expect and how to prepare. But sometimes it’s worse. So I tell people I hope it’ll be easier, but there’s no guarantee. If you notice something different, let me know.”
Can both knees or both hips be replaced on the same day?
It can be done, but I tend to shy away from it. Replacing both knees on the same day is like signing up for two car wrecks on the same day: your body takes on double the physical stress at once, and the medical risk goes up with it. It is only for patients who are very healthy, in unusual situations.
Replacing both hips on the same day is even less common. It can technically be done too, but only with very careful patient selection. For most people, doing one side, recovering, and then doing the other is the safer path.
“Bilateral knee replacement can be done, but it’s really like signing up for two car wrecks on the same day. The patient has to be very healthy, in very unique situations, and I tend to shy away from it because of the medical risk.”
I need a hip and a knee. Which should I do first?
If one is clearly worse than the other, we usually do the worse one first.
If they hurt about the same, I usually recommend the hip first. A bad hip gets irritated by knee replacement recovery, especially the physical therapy a new knee needs, and a painful hip can hold back a knee recovery more than the other way around. After a knee replacement, therapy is not optional, and you want a hip that can handle it.
It is also worth knowing that hip arthritis can cause pain you feel in the knee. Before planning two surgeries, make sure the knee pain is really coming from the knee. More on that in knee pain that actually comes from the hip.
How should I prepare for the second surgery?
Use what you learned the first time. Set up the house the way that worked. Get back to your prehab exercises before surgery: the stronger you come to surgery, the better you will do. And bring your questions from the first recovery to your pre-op visit, including anything that surprised you.
When should I call my surgeon during the second recovery?
The same signs matter the second time: a swollen, red, or painful calf; a fever above 101.5 degrees Fahrenheit; drainage from the incision; pain that suddenly gets far worse. And anything that feels different from your first recovery in a way that worries you. If you’re worried, I’m worried. Our clinic number is answered 24 hours a day.
Joint replacement in Franklin, Nashville, and Middle Tennessee
I perform hip and knee replacements at the Bone and Joint Institute of Tennessee in Franklin, on the Williamson Health campus, for patients from Franklin, Brentwood, Nashville, Spring Hill, Nolensville, Murfreesboro, and across Middle Tennessee. If you are weighing a second replacement, or a hip and a knee, we can plan the order and timing together. Schedule a consultation.
This article is for educational purposes only and does not replace personalized medical advice. Timing and treatment decisions depend on individual health factors; always follow the guidance of your own surgeon. In an emergency, call 911.
